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1.  Erratum 
Paediatrics & Child Health  2014;19(8):448.
PMCID: PMC4220533  PMID: 25382551
2.  Erratum 
Paediatrics & Child Health  2014;19(7):345.
PMCID: PMC4173897
3.  Letter to the Editor 
Paediatrics & Child Health  2014;19(7):345.
PMCID: PMC4173896  PMID: 25332666
4.  Sex disparity and perception of obesity/overweight by parents and grandparents 
Paediatrics & Child Health  2014;19(7):346.
OBJECTIVE:
To explore the factors associated with the sex disparity showing a greater prevalence of obesity/overweight in boys compared with girls in Chinese school children.
METHODS:
Sampled students and their parents were asked to complete a questionnaire. Perceptions of weight status by the parents, grandparents and children themselves were collected. A logistic regression analysis was used.
RESULTS:
The sampled students included 327 obese/overweight students and 1078 students with normal body mass index (BMI). The crude OR of obesity/overweight for boys compared with girls was 1.57 (95% CI 1.22 to 2.01). The increased risk of childhood obesity/overweight for boys remained after adjustment for prenatal and infant factors, daily habits and family situation, but disappeared after adjustment for perception of weight status (OR 1.27 [95% CI 0.93 to 1.67]). There were differences in underestimation of children’s weight status between boys and girls by their parents and grandparents (OR 1.33 [95% CI 1.08 to 1.64] and OR 1.42 [95% CI 1.15 to 1.75], respectively).
CONCLUSIONS:
Misconceptions about a child’s weight status were prevalent among parents and grandparents, and boys’ weight status was more frequently underestimated than girls. The disparity of underestimating weight according to sex may partially contribute to the difference in the prevalence of obesity/overweight between boys and girls among Chinese school children.
PMCID: PMC4173898  PMID: 25332668
Children; Obesity; Overweight; Perception; Prevalence; Sex
9.  Beta2-agonists for exercise-induced asthma 
Paediatrics & Child Health  2014;19(7):355-356.
PMCID: PMC4173903  PMID: 25332673
10.  Recognizing and responding to parental mental health needs: What can we do now? 
Paediatrics & Child Health  2014;19(7):357-361.
Early daily interactions in a child’s life, frequent and positive, are crucial to optimal human development. The negative effects of maternal depression may include her perception of the child, the child’s cognitive development and future antisocial behaviour. Emerging research investigating paternal depression is also concerning. Signs of maternal depression can be observed through either an intrusive or withdrawn maternal-infant interaction. The particular role of poverty, which affects so many Canadian families, is highlighted. Furthermore, the benefits and risks of screening for parental depression are discussed. Approaches available to the physician to address this issue using available resources are outlined.
PMCID: PMC4173904  PMID: 25332674
Early years; Mental health; Parent
11.  Canadian paediatric asthma action plans and their correlation with current consensus guidelines 
Paediatrics & Child Health  2014;19(7):362-366.
BACKGROUND:
While written action plans are standard in the treatment and management of asthma, significant variability exists in the content and format among plans. This variability results in inconsistent educational messages that lend themselves to patient confusion and suboptimal health outcomes.
OBJECTIVES:
To assess the content of Canadian paediatric written action plans for consistency in format, layout, zone-defining symptoms, suggested treatment options and adherence to current Canadian asthma care guidelines.
METHODS:
Written action plans were sought from Canadian paediatric hospitals, major teaching hospitals associated with academic centres and three national organizations, for a total of 17 plans. An analysis was performed to assess the similarities and differences among plans.
RESULTS:
Of all the Canadian paediatric written action plans, 76% were found to consist of three zones and 82% incorporated a traffic light-style design. The plans were divided between symptom-based (59%) and combined symptom- and peak-flow rate approaches (41%). Nominal concordance with the 2012 Canadian Thoracic Society guidelines existed with respect to inhaled corticosteroid and oral corticosteroid therapy. Considerable variability existed among the symptom descriptors that defined each zone. Greater consistency existed among treatment strategies, although the suggested treatment was often difficult to ascertain from the plan templates.
CONCLUSION:
Canadian written action plans would be improved by nationally clarifying the symptom descriptors for each zone, adding asthma trigger information to the plans, increasing the emphasis of the common cold as a potential harbinger of worsening asthma symptoms and further incorporating national guideline recommendations.
PMCID: PMC4173905  PMID: 25332675
Asthma; Disease management; Practice guidelines; Written action plans
12.  Paediatric sleep resources in Canada: The scope of the problem 
Paediatrics & Child Health  2014;19(7):367-372.
BACKGROUND:
Sleep-disordered breathing (SDB) is prevalent in children and is associated with significant comorbidity.
OBJECTIVES:
To describe paediatric sleep physician and diagnostic testing resources for SDB in Canadian children.
METHODS:
A 38-item, Internet-based survey was sent to the 32 members of the Canadian Pediatric Sleep Network (CPSN). A shorter telephone survey was administered to all 182 non-CPSN sleep laboratories across Canada.
RESULTS:
Responses were obtained from 29 of 31 (91%) CPSN members and 121 of 182 (66%) non-CPSN sleep facilities. Sixty-seven of 121 (55%) of the responding non-CPSN facilities reported that they see children <18 years of age. Thirty-six of 121 (30%) and 23 of 121 (19%), respectively, see children ≤12 years of age or ≤8 years of age. Marked disparities across provinces/territories were observed, with no practitioners or polysomnography in the Yukon, Northwest Territories, Nunavut, Saskatchewan, New Brunswick, Prince Edward Island, and Newfoundland and Labrador. Alberta has the smallest ratio of children to practitioners (approximately 167,000 to 1) and Ontario has the smallest ratio of children to polysomnograms performed per year (approximately 487,000 to 1). Reported wait times for polysomnography ranged from <1 month, to 1.5 to 2 years. In paediatric tertiary care centres, the number of polysomnograms performed per year ranged from 55 to 700 (median 480) and in other laboratories the range was 400 to 4000 (median 1100).
CONCLUSIONS:
The present study demonstrates a significant lack of resources and services for paediatric SDB care across Canada, with pronounced geographical disparities. Even if only affected children were tested with polysomnography, the authors estimate there are 7.5 times more children with SDB than current testing capacity.
PMCID: PMC4173906  PMID: 25332676
Health services; Paediatrics; Polysomnography; Respirology; Sleep clinic; Sleep physicians; Survey
13.  A simulation-based intervention teaching seizure management to caregivers: A randomized controlled pilot study 
Paediatrics & Child Health  2014;19(7):373-378.
OBJECTIVES:
To examine the effect of simulation-based seizure management teaching on improving caregiver competence and reported confidence with managing seizures. The authors hypothesized that simulation-based education would lead to a higher level of demonstrated competence and reported confidence in family members and caregivers. Simulation has not been previously studied in this context.
METHODS:
A two-group pre- and post-test experimental research design involving a total of 61 caregivers was used. The intervention was a simulation-based seizure curriculum delivered as a supplement to traditional seizure discharge teaching. Caregiver performance was analyzed using a seizure management checklist. Caregivers’ perception of self-efficacy was captured using a self-efficacy questionnaire.
RESULTS:
Caregivers in the experimental group achieved significantly higher postintervention performance scores than caregivers in the control group in both premedication and postmedication seizure management (P<0.01). Additionally, they achieved significantly higher scores on the self-efficacy questionnaire including items reflecting confidence managing the seizure at home (P<0.05).
CONCLUSION:
Caregivers receiving the supplemental simulation-based curriculum achieved significantly higher levels of competence and reported confidence, supporting a positive relationship between simulation-based seizure discharge education, and caregiver competence and confidence in managing seizures. Simulation sessions provided insight into caregiver knowledge but, more importantly, insight into the caregiver’s ability to apply knowledge under stressful conditions, allowing tailoring of curriculum to meet individual needs. These findings may have applications and relevance for management of other acute or chronic medical conditions.
PMCID: PMC4173907  PMID: 25332677
Competence; Education; Family; Family-centred care; Mastery learning; Simulation
14.  Lyme disease in Canada: Focus on children 
Paediatrics & Child Health  2014;19(7):379-383.
Lyme disease, the most common tick-borne infection in Canada and much of the United States, is caused by the bacteria Borrelia burgdorferi. Peak incidence for Lyme disease is among children five to nine years of age and older adults (55 to 59 years of age). The bacteria are transmitted through the bite of infected black-legged ticks of the Ixodes species. The primary hosts of black-legged ticks are mice and other rodents, small mammals, birds (which are reservoirs for B burgdorferi) and white-tailed deer. Geographical distribution of Ixodes ticks is expanding in Canada and an increasing number of cases of Lyme disease are being reported. The present practice point reviews the epidemiology, clinical presentation, diagnosis, management and prevention of Lyme disease, with a focus on children.
PMCID: PMC4173908  PMID: 25332678
Black-legged tick; Borrelia burgdorferi; Erythema migrans; Post-treatment Lyme disease syndrome
17.  Sex disparity and perception of obesity/overweight by parents and grandparents 
Paediatrics & Child Health  2014;19(7):e113-e116.
OBJECTIVE:
To explore the factors associated with the sex disparity showing a greater prevalence of obesity/overweight in boys compared with girls in Chinese school children.
METHODS:
Sampled students and their parents were asked to complete a questionnaire. Perceptions of weight status by the parents, grandparents and children themselves were collected. A logistic regression analysis was used.
RESULTS:
The sampled students included 327 obese/overweight students and 1078 students with normal body mass index (BMI). The crude OR of obesity/overweight for boys compared with girls was 1.57 (95% CI 1.22 to 2.01). The increased risk of childhood obesity/overweight for boys remained after adjustment for prenatal and infant factors, daily habits and family situation, but disappeared after adjustment for perception of weight status (OR 1.27 [95% CI 0.93 to 1.67]). There were differences in underestimation of children’s weight status between boys and girls by their parents and grandparents (OR 1.33 [95% CI 1.08 to 1.64] and OR 1.42 [95% CI 1.15 to 1.75], respectively).
CONCLUSIONS:
Misconceptions about a child’s weight status were prevalent among parents and grandparents, and boys’ weight status was more frequently underestimated than girls. The disparity of underestimating weight according to sex may partially contribute to the difference in the prevalence of obesity/overweight between boys and girls among Chinese school children.
PMCID: PMC4173911  PMID: 25332680
Children; Obesity; Overweight; Perception; Prevalence; Sex
18.  My modus operandi 
Paediatrics & Child Health  2014;19(1):7-8.
PMCID: PMC3938211  PMID: 24627646
19.  Topical nitroglycerin in neonates with tissue injury: A case report and review of the literature 
Paediatrics & Child Health  2014;19(1):9-12.
Peripheral tissue injury is one of the well-described morbidities associated with stays in the neonatal intensive care unit. Despite the potential long-term disability associated with this event, the current available therapeutic options remain very limited. Topical nitroglycerin has emerged as a promising agent for the treatment of tissue injury in infants. The present article includes a review of the currently available evidence on the use of topical nitroglycerin in the neonatal population, and describes a unique case involving successful use of 2% nitroglycerin in the late treatment of prolonged tissue ischemia in a newborn infant.
PMCID: PMC3938212  PMID: 24627647
Infants; Tissue injury; Topical nitroglycerin
20.  Speech and language support: How physicians can identify and treat speech and language delays in the office setting 
Paediatrics & Child Health  2014;19(1):13-18.
Failure to recognize and intervene early in speech and language delays can lead to multifaceted and potentially severe consequences for early child development and later literacy skills. While routine evaluations of speech and language during well-child visits are recommended, there is no standardized (office) approach to facilitate this. Furthermore, extensive wait times for speech and language pathology consultation represent valuable lost time for the child and family. Using speech and language expertise, and paediatric collaboration, key content for an office-based tool was developed.
The tool aimed to help physicians achieve three main goals: early and accurate identification of speech and language delays as well as children at risk for literacy challenges; appropriate referral to speech and language services when required; and teaching and, thus, empowering parents to create rich and responsive language environments at home. Using this tool, in combination with the Canadian Paediatric Society’s Read, Speak, Sing and Grow Literacy Initiative, physicians will be better positioned to offer practical strategies to caregivers to enhance children’s speech and language capabilities.
The tool represents a strategy to evaluate speech and language delays. It depicts age-specific linguistic/phonetic milestones and suggests interventions. The tool represents a practical interim treatment while the family is waiting for formal speech and language therapy consultation.
PMCID: PMC3938213  PMID: 24627648
Child development; Early years; Health care delivery; Language; Speech
25.  Epigenetics: What does it mean for paediatric practice? 
Paediatrics & Child Health  2014;19(1):27-30.
‘Epigenetics’ involves the study of gene expression and the environmental exposures that influence expression. In paediatrics, it is recognized that different physiological and developmental stages of the young individual are affected by both genetic control and environmental influence. It appears that changes in gene expression – not changes in the DNA itself – can be passed on from one generation to another. The importance for paediatricians is recognizing disorders involving epigenetics, recording events during childhood that could affect epigenetic control of gene expression, and being aware of new therapies as they become available. Paediatricians need to be able to recognize the relevant risk factors.
PMCID: PMC3938218  PMID: 24627653
Chromatin; Developmental origins of health and disease; Epigenetics; Gene control; Histones; Imprinting; Methylation; Paediatrics

Results 1-25 (1070)